and conflict resolution skills.The client was assigned “Applying Problem-Solving to Interpersonal Conflict” in the Adult Psychotherapy Homework Planner (Jongsma & Bruce).The client was reinforced for increased use of assertiveness, problem-solving, and conflict resolution skills with the significant other.The client's significant other was urged to assist the client in use of assertiveness, problem-solving, and conflict resolution skills.The client has not regularly used assertiveness, problem-solving, and conflict resolution skills with the significant other and was assisted in identifying barriers to this success.33 Construct Strategy for Managing Anger (33)The client was assisted in constructing a client-tailored strategy for managing anger.The client was encouraged to combine somatic, cognitive, communication, problem-solving, and conflict resolution skills relevant to their needs.The client was reinforced for their comprehensive anger management strategy.The client was redirected to develop a more comprehensive anger management strategy.
34 Select Challenging Situations for Managing Anger (34)The client was provided with situations in which they may be increasingly challenged to apply new strategies for managing anger.The client was asked to identify likely upcoming challenging situations for managing anger.The client was urged to use strategies for managing anger in successively more difficult situations.
35 Consolidate Anger Management Skills (35)Techniques were used to help the client consolidate new anger management skills.Techniques such as relaxation, imagery, behavioral rehearsal, modeling, role-playing, or in vivo exposure/behavioral experiences were used to help the client consolidate the use of new anger management skills.The client's use of techniques to consolidate anger management skills was reviewed and reinforced.
36 Monitor/Decrease Outbursts (36)The client's reports of angry outbursts were monitored, toward the goal of decreasing their frequency, intensity, and duration.The client was urged to use new anger management skills to decrease the frequency, intensity, and duration of anger outbursts.The client was assigned “Alternatives to Destructive Anger” in the Adult Psychotherapy Homework Planner (Jongsma & Bruce).The client's progress in decreasing angry outbursts was reviewed.The client was reinforced for success at decreasing the frequency, intensity, and duration of anger outbursts.The client has not decreased the frequency, intensity, or duration of anger outbursts and corrective feedback was provided.
37 Differentiate Between Lapse and Relapse (37)A discussion was held with the client regarding the distinction between a lapse and a relapse.A lapse was associated with an initial and reversible return of angry outbursts.A relapse was associated with the decision to return to the old pattern of anger.The client was provided with support and encouragement as they displayed an understanding of the difference between a lapse and a relapse.The client struggled to understand the difference between a lapse and a relapse and was provided with remedial feedback in this area.
38 Discuss Management of Lapse Risk Situations (38)The client was assisted in identifying future situations or circumstances in which lapses could occur.The session focused on rehearsing the management of future situations or circumstances in which lapses could occur.The client was reinforced for appropriate use of lapse management skills.The client was redirected in regard to poor use of lapse management skills.
39 Encourage Routine Use of Strategies (39)The client was instructed to routinely use the strategies learned in therapy (e.g., calming adaptive self-talk, assertion, and/or conflict resolution).The client was urged to find ways to build new strategies into daily life as much as possible.The client was reinforced while reporting ways in which they have incorporated coping strategies into their life and routine.The client was redirected about ways to incorporate new strategies into their routine and life.
40 Develop a “Coping Card” (40)The client was provided with a “coping card” on which specific coping strategies were listed.The client was assisted in developing the “coping card” in order to list helpful coping strategies.The client was encouraged to use the “coping card” when struggling with anger-producing situations.
41 Schedule “Maintenance” Sessions (41)The client was assisted in scheduling “maintenance” sessions to help maintain therapeutic gains and adjust to life without angry outbursts.Positive feedback was provided to the client for maintenance of therapeutic gains.The client has displayed an increase in anger symptoms and was provided with additional relapse prevention strategies.
42 Encourage Disclosure (42)The client was encouraged to discuss anger management goals with trusted persons who are likely to support the change.The client was assisted in identifying individuals who are likely to support the change.The client has reviewed anger management goals with trusted persons and their responses were processed.The client has not discussed anger management goals and was redirected to do so.
43 Use the ACT Approach (43)The use of acceptance and commitment therapy (ACT) was applied.The client was assisted in accepting and openly experiencing angry thoughts and feelings, without being overly affected by them.The client was assisted in committing time and efforts to activities that are consistent with identified personally meaningful values.The client has engaged well with the ACT approach and applied these concepts to their symptoms and lifestyle.The client has not engaged well with the ACT approach and remedial efforts were applied.
44 Teach Mindfulness Meditation (44)The client was taught mindfulness meditation techniques to help recognize negative thought processes associated with anger.The client was taught to focus on changing their relationship with the anger-related thoughts by accepting the thoughts, images, and impulses that are reality-based while noticing, but not reacting to, nonreality-based mental phenomenon.The client was assisted in differentiating between reality-based thoughts and nonreality-based thoughts.The client has used mindfulness meditation to help overcome negative thought processes that trigger anger and was reinforced for this.The client has struggled to apply mindfulness meditation and was provided with remedial assistance in this area.
45 Assign ACT Homework (45)The client was assigned homework situations in which the client practices lessons from mindfulness meditation and ACT.The client was assisted in consolidating mindfulness meditation and ACT approaches into everyday life.
46 Assign Reading on Mindfulness and ACT (46)The client was assigned reading material consistent with mindfulness and the ACT approach to supplement work done in session.The client has read assigned material and key concepts were processed.The client has not read assigned material and was redirected to do so.
47 Identify Anger Expression Models (47)The client was assisted in identifying key figures in their life who have provided examples of how to positively or negatively express anger.The client was reinforced in identifying several key figures who have been negative role models in expressing anger explosively and destructively.The client was supported and reinforced while acknowledging that they manage anger in the same way that an explosive parent figure had done when the client was growing up.The client was encouraged to identify positive role models throughout their life whom they could respect for their management of angry feelings.The client was supported while acknowledging that others have been influential in teaching destructive patterns of anger management.The client failed to identify key figures in their life who have provided examples as to how to positively express anger and was questioned more specifically in this area.
48 Teach Anger Effects (48)The client was educated regarding the ways in which anger blocks the awareness of pain, discharges uncomfortable feelings, erases guilt, and places the blame on others for problems.The client verbalized an understanding of how anger blocks the awareness of pain, discharges uncomfortable feelings, erases guilt, and places the blame for problems on others; this insight was reinforced.The client's understanding of the effects of anger has resulted in the client demonstrating improved anger management; this progress was highlighted.The client did not accept the relationship between how anger blocks the awareness of pain, discharges uncomfortable feelings, erases guilt, and places the blame on others for problems; the client was urged to continue to consider this relationship.
49 Develop
